Oriented, molecularly imprinted cavities with dual binding sites for highly sensitive and selective recognition of cortisol

Advancements in Cortisol Detection: From Conventional Methods to Next-Generation Technologies for Enhanced Hormone Monitoring

The hormone cortisol, released as the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, has a well-characterized circadian rhythm that enables an allostatic response to external stressors. When the pattern of secretion is disrupted, cortisol levels are chronically elevated, contributing to diseases such as heart attacks, strokes, mental health disorders, and diabetes. The diagnosis of chronic stress and stress related disorders depends upon accurate measurement of cortisol levels; currently, it is quantified using mass spectroscopy or immunoassay, in specialized laboratories with trained personnel. However, these methods are time-consuming, expensive and are unable to capture the dynamic biorhythm of the hormone. This critical review traces the path of cortisol detection from traditional laboratory-based methods to decentralised cortisol monitoring biosensors. A complete picture of cortisol biology and pathophysiology is provided, and the importance of precision medicine style monitoring of cortisol is highlighted. Antibody-based immunoassays still dominate the pipeline of development of point-of-care biosensors; new capture molecules such as aptamers and molecularly imprinted polymers (MIPs) combined with technologies such as microfluidics, wearable electronics, and quantum dots offer improvements to limit of detection (LoD), specificity, and a shift toward rapid or continuous measurements. While a variety of different sensors and devices have been proposed, there still exists a need to produce quantitative tests for cortisol ─ using either rapid or continuous monitoring devices that can enable a personalized medicine approach to stress management. This can be addressed by synergistic combinations of technologies that can leverage low sample volumes, relevant limit of detection and rapid testing time, to better account for cortisol's shifting biorhythm. Trends in cortisol diagnostics toward rapid and continuous monitoring of hormones are highlighted, along with insights into choice of sample matrix.

Clinical Endocrinology-Time for a Reset?

Measurement of blood levels of circulating hormones has always been the cornerstone of the biochemical diagnosis of endocrine diseases, with the objective of detecting hormone excess or insufficiency. Unfortunately, the dynamic nature of hormone secretion means single-point measurements of many hormones often lack diagnostic validity. Endocrinologists have devised complex dynamic tests as indirect assessments of the functioning of the hormone system under investigation. Recent advances in the measurement of dynamic hormone changes across the day now offer an opportunity to reconsider whether there might be better ways both to diagnose and to monitor the therapy of endocrine conditions.

Signal transduction interfaces for field-effect transistor-based biosensors

Biosensors based on field-effect transistors (FETs) are suitable for use in miniaturized and cost-effective healthcare devices. Various semiconductive materials can be applied as FET channels for biosensing, including one- and two-dimensional materials. The signal transduction interface between the biosample and the channel of FETs plays a key role in translating electrochemical reactions into output signals, thereby capturing target ions or biomolecules. In this Review, distinctive signal transduction interfaces for FET biosensors are introduced, categorized as chemically synthesized, physically structured, and biologically induced interfaces. The Review highlights that these signal transduction interfaces are key in controlling biosensing parameters, such as specificity, selectivity, binding constant, limit of detection, signal-to-noise ratio, and biocompatibility.

Wearable and Implantable Cortisol-Sensing Electronics for Stress Monitoring

Cortisol is a steroid hormone that is released from the body in response to stress. Although a moderate level of cortisol secretion can help the body maintain homeostasis, excessive secretion can cause various diseases, such as depression and anxiety. Conventional methods for cortisol measurement undergo procedures that limit continuous monitoring, typically collecting samples of bodily fluids, followed by separate analysis in a laboratory setting that takes several hours. Thus, recent studies demonstrate wearable, miniaturized sensors integrated with electronic modules that enable wireless real-time analysis. Here, the primary focus is on wearable and implantable electronic devices that continuously measure cortisol concentration. Diverse types of cortisol-sensing techniques, such as antibody-, DNA-aptamer-, and molecularly imprinted polymer-based sensors, as well as wearable and implantable devices that aim to continuously monitor cortisol in a minimally invasive fashion are discussed. In addition to the cortisol monitors that directly measure stress levels, other schemes that indirectly measure stress, such as electrophysiological signals and sweat are also summarized. Finally, the challenges and future directions in stress monitoring and management electronics are reviewed.

Molecularly Imprinted Polymer-Based Sensor for Electrochemical Detection of Cortisol

As a steroid hormone, cortisol has a close relationship with the stress response, and therefore, can be used as a biomarker for early detection of stress. An electrochemical immunosensor is one of the most widely used methods to detect cortisol, with antibodies as its bioreceptor. Apart from conventional laboratory-based methods, the trend for cortisol detection has seemed to be exploiting antibodies and aptamers. Both can provide satisfactory performance with high selectivity and sensitivity, but they still face issues with their short shelf life. Molecularly imprinted polymers (MIPs) have been widely used to detect macro- and micro-molecules by forming artificial antibodies as bioreceptors. MIPs are an alternative to natural antibodies, which despite demonstrating high selectivity and a low degree of cross-reactivity, often also show a high sensitivity to the environment, leading to their denaturation. MIPs can be prepared with convenient and relatively affordable fabrication processes. They also have high durability in ambient conditions, a long shelf life, and the ability to detect cortisol molecules at a concentration as low as 2 ag/mL. By collecting data from the past five years, this review summarizes the antibody and aptamer-based amperometric sensors as well as the latest developments exploiting MIPs rather than antibodies. Lastly, factors that can improve MIPs performance and are expected to be developed in the future are also explained.

Development of a Redox-Label-Doped Molecularly Imprinted Polymer on β-Cyclodextrin/Reduced Graphene Oxide for Electrochemical Detection of a Stress Biomarker

Cortisol is a major stress biomarker involved in the regulation of metabolic and immune responses. Readily accessible assays with sufficient quantitative and temporal resolution can assist in prevention, early diagnosis, and management of chronic diseases. Whereas conventional assays are costly in terms of time, labor, and capital, an electrochemical approach offers the possibility of miniaturization and detection at the point-of-care. Here, we investigate the biosensor application of molecularly imprinted polypyrrole (PPy) doped with hexacyanoferrate (HCF) and coupled to reduced graphene oxide functionalized with β-cyclodextrin (β-CD). β-CD provides an inclusion site for lipophilic cortisol and was electrochemically grafted simultaneous with reduction of GO. Next, PPy was electrochemically deposited in presence of cortisol template with HCF dopant ions serving as intrinsic redox probe. Thus, the sensor response was evaluated via changes of redox peak current in cyclic voltammetry and demonstrated a broad logarithmic detection range (5 pg/mL to 5000 ng/mL, R ² = 0.995), with a sensitivity of 8.809 μA log^-1 (ng/mL) cm^-2 and LOD of 19.3 pM. The sensor was shown to be specific toward cortisol in reference to salivary cortisol concentration in saliva over structural analogues. The sensor was exhibited to determine cortisol in artificial saliva at normal and elevated levels. The good performance and facile electrochemical fabrication of this antibody- and external label-free interface are promising for the development of affordable point-of-care biosensors.

Assessing doping strategies for monolayer MoS2 towards non-enzymatic detection of cortisol: a first-principles study

In this work, we investigate by means of atomistic density functional theory simulations the interaction between cortisol (the target molecule) and monolayer MoS₂ (the substrate). The aim is to assess viable strategies for the non-enzymatic chemical sensing of cortisol. Metal doping of the sensing material could offer a way to improve the device response upon analyte adsorption, and could also enable novel and alternative detection mechanisms. For such reasons, we explore metal doping of MoS₂ with Ni, Pd, and Pt, as these are metal elements commonly used in experiments. Then, we study the material response from the structural, electronic, and charge-transfer points of view. Based on our results, we propose two possible sensing mechanisms and device architectures: (i) a field-effect transistor, and (ii) an electrochemical sensor. In the former, Ni-doped MoS₂ would act as the FET channel, and the sensing mechanism involves the variation of the surface electrostatic charge upon the adsorption of cortisol. In the latter, MoS₂ decorated with Pt nanoparticles could act as the working electrode, and the sensing mechanism would involve the reduction of cortisol. In addition, our findings may suggest the suitability of both doped and metal-doped MoS₂ as sensing layers in an optical sensor.

Protein-imprinted polymer films prepared via cavity-selective multi-step post-imprinting modifications for highly selective protein recognition

The use of molecularly imprinted polymers (MIPs) for achieving synthetic receptors capable of selective molecular recognition is promising; however, these polymers exhibit low selectivity derived from the heterogeneity of their created, imprinted cavities. To achieve highly selective protein recognition, we herein report the cavity-selective, multi-step, post-imprinting modification of MIPs. An MIP film for lysozyme was prepared by the copolymerization of {[2-(2-methacrylamido)ethyldithio]ethylcarbamoyl}methoxy acetic acid, a functional monomer possessing a modifiable disulfide bond, with acrylamide and N,N'-methylenebisacrylamide in the presence of lysozyme. After the removal of lysozyme, the disulfide bonds were cleaved by treatment with a reductant. A low concentration of lysozyme was then added to occupy the high-affinity cavities of the polymer and sterically protect the thiol groups within them. A poly(ethylene glycol)-based capping agent was reacted with the thiol groups residing in low-affinity cavities to hinder them. After the regeneration of the high-affinity cavities by washing out the bound lysozyme, the remaining thiol groups were reacted with 3-(2-pyridyldithio)propionic acid to introduce interacting groups, which produced capped MIPs. Comparing the capped and uncapped MIPs revealed that off-target protein binding was effectively suppressed by the capping treatment without any reduction in binding affinity (1.1 × 10⁹ M^-1). Further investigation revealed that the lysozyme concentration during the capping process is critical for the selectivity of the capped MIP. In this case, highly selective MIPs were achieved when the lowest lysozyme concentration (100 nM) was used. This facile process for creating highly selective, synthetic polymer receptors is a powerful approach for achieving plastic antibodies.

Recent Advances of Molecularly Imprinted Polymers Based on Cyclodextrin

Molecular imprinting polymers (MIPs), generally considered as artificial mimics that are comparable to natural receptor, are polymers with tailor-made specific recognition sites complementary to the template molecules in shape and size. As a class of supramolecular compounds, cyclodextrins (CDs) are flourishing in the field of molecular imprinting with their unique structural properties. This review presents recent advances in application of MIPs based on CDs during the past five years. The discussion is grouped according to the different role of CDs in MIPs, that is, functional monomer, carrier modifier, etc. Main focus is the application of CD-based MIP on sample preparation, detection, and sensing. Additionally, drug delivery with CD-based MIP is also briefly discussed. Finally, challenges and future prospects of application of CDs in MIP are elaborated.

Oriented Immobilization of Protein Templates: A New Trend in Surface Imprinting

In this Review, we have summarized recent trends in protein template imprinting. We emphasized a new trend in surface imprinting, namely, oriented protein immobilization. Site-directed proteins were assembled through specially selected functionalities. These efforts resulted in a preferably oriented homogeneous protein construct with decreased protein conformation changes during imprinting. Moreover, the maximum functionality for protein recognition was utilized. Various strategies were exploited for oriented protein immobilization, including covalent immobilization through a boronic acid group, metal coordinating center, and aptamer-based immobilization. Moreover, we have discussed the involvement of semicovalent as well as covalent imprinting. Interestingly, these approaches provided additional recognition sites in the molecular cavities imprinted. Therefore, these molecular cavities were highly selective, and the binding kinetics was improved.

Hexagonally Packed Macroporous Molecularly Imprinted Polymers for Chemosensing of Follicle-Stimulating Hormone Protein

Homogenous nanostructuration of molecularly imprinted polymer (MIP) films for follicle-stimulating hormone (FSH)-sensing was achieved by using optimized colloidal crystals as a hard mold. Introduction of a heating step after assembling colloidal crystals of silica beads promoted their adhesion. Thus, precise assembling of beads was not disturbed during further multisteps of surface imprinting, and crack-free hexagonal packing was maintained. Scanning electron microscopy imaging confirmed hexagonal packing of silica colloidal crystals as well as homogenous nanostructuration in MIP films. FSH immobilization over silica beads and later its derivatization with electroactive functional monomers was confirmed by X-ray photoelectron spectroscopy analysis. The nanostructured molecular recognition films prepared in this way were combined with an electrochemical transducer in order to design a capacitive impedimetry-based chemosensing system. It was tested for the determination of FSH in the range from 0.1 fM to 100 pM in 10 mM 2-(N-morpholino) ethane sulfonic acid buffer (pH = 4.2). The detection limit of the chemosensor was 0.1 fM, showing a high selectivity with respect to common protein interferences as well as other protein hormones of the gonadotropin family.

A multichannel system integrating molecularly imprinted conductive polymers for ultrasensitive voltammetric determination of four steroid hormones in urine

This work reports on a modularized electrochemical method for the determination of the hormones cortisol, progesterone, testosterone and 17β-estradiol in urine. These hormones were employed as templates when generating molecular imprints from aniline and metanilic acid by electropolymerization on the surface of screen-printed electrodes. The electrically conductive imprint was characterized by SEM, AFM and cyclic voltammetry. A four-channel system was then established to enable simultaneous determination of the hormones by cyclic voltammetry. The detection limits for cortisol, progesterone, testosterone and 17β-estradiol are as low as 2, 2.5, 10 and 9 ag·mL^-1 (for S/N = 3). Graphical abstract A four-channel system was established to enable simultaneous determination of 4 steroid hormones by cyclic voltammetry and by using moleculalry imprinted polymers.

Molecularly Imprinted Polymer-Based Hybrid Materials for the Development of Optical Sensors

We report on the development of new optical sensors using molecularly imprinted polymers (MIPs) combined with different materials and explore the novel strategies followed in order to overcome some of the limitations found during the last decade in terms of performance. This review pretends to offer a general overview, mainly focused on the last 3 years, on how the new fabrication procedures enable the synthesis of hybrid materials enhancing not only the recognition ability of the polymer but the optical signal. Introduction describes MIPs as biomimetic recognition elements, their properties and applications, emphasizing on each step of the fabrication/recognition procedure. The state of the art is presented and the change in the publication trend between electrochemical and optical sensor devices is thoroughly discussed according to the new fabrication and micro/nano-structuring techniques paving the way for a new generation of MIP-based optical sensors. We want to offer the reader a different perspective based on the materials science in contrast to other overviews. Different substrates for anchoring MIPs are considered and distributed in different sections according to the dimensionality and the nature of the composite, highlighting the synergetic effect obtained as a result of merging both materials to achieve the final goal.

Functional materials generated by allying cyclodextrin-based supramolecular chemistry with living polymerization

Cyclodextrin molecules are cyclic oligosaccharides that display a unique structure including an inner side and two faces on their outer sides.